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The use of medication against attention deficit/hyperactivity disorder in Denmark: a drug use study from a patient perspective

  • Pharmacoepidemiology and Prescription
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Abstract

Aim

Our aim was to characterize utilization patterns for drugs used to treat attention deficit/hyperactivity disorder (ADHD) on the level of the individual patient among Danish users, focusing on treatment duration, doses used, and concurrent use of ADHD and non-ADHD drugs.

Methods

Using the Danish Registry of Medicinal Product Statistics, we extracted data on 1,085,099 prescriptions for ADHD drugs issued to a total of 54,024 persons in the study period 1 January 1995 to 30 September 2011. For users in the final year of the study period, we further extracted 315,365 prescriptions for non-ADHD drugs. Drug utilization was characterized using descriptive statistics.

Results

The mean duration of ADHD treatment was highest (3.6–4.2 years) for patients initiating therapy at a young age (age<13). Dropout rate after receiving only one prescription was highest among off-label users (age<6 and age >17). All age categories showed an increase in the average daily dosage of methylphenidate used from 2003 to 2010. Concomitant treatment with methylphenidate and atomoxetine was rare, as only 2 % of methylphenidate treatment overlapped with atomoxetine treatment. Nineteen percent of methylphenidate instant-release treatment overlapped with methylphenidate controlled-release treatment. Users of ADHD drugs across all age categories had an increased use of drugs related to the nervous system, especially antipsychotics [standardized morbidity rate (SMR), 6.4–19.5] and antiepileptics (SMR, 4.0–5.5).

Conclusion

We found certain traits that warrant further investigation: the apparent increase in average daily doses, the low adherence to treatment among off-label users, and the increased use of other psychotropic medication.

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Acknowledgments

The authors would like to thank Steffen Thirstrup for comments on the study protocol and Tora Hammer for valuable comments on the manuscript.

Conflicts of interest

Jesper Hallas has participated in research projects funded by Novartis with grants paid to the institution where he was employed. He has personally received fees for teaching or consulting from the Danish Association of Pharmaceutical Manufacturers and from Novartis. The remaining authors declare that they have no potential conflicts of interest.

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Authors and Affiliations

  1. Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Winsløwparken 19, 2, 5000, Odense C, Denmark

    Anton Pottegård & Jesper Hallas

  2. Institute for Rational Pharmacotherapy, Danish Health and Medicines Authority, Axel Heides Gade 1, 2300, København S, Denmark

    Anton Pottegård, Dorte Glintborg & Søren Ilsøe Moreno

  3. Medicines Control Division, Statistics and Analysis, Danish Medicines Agency, Axel Heides Gade 1, 2300, København S, Denmark

    Bine Kjøller Bjerregaard

  4. Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Harald Selmers Vej 66, 8240, Risskov, Denmark

    Lisbeth Sandal Kortegaard

  5. Clinical Pharmacology, University of Southern Denmark, JB Winsløwsvej 19, 2, 5000, Odense C, Denmark

    Anton Pottegård

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  1. Anton Pottegård
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Correspondence to Anton Pottegård.

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Pottegård, A., Bjerregaard, B.K., Glintborg, D. et al. The use of medication against attention deficit/hyperactivity disorder in Denmark: a drug use study from a patient perspective. Eur J Clin Pharmacol 69, 589–598 (2013). https://doi.org/10.1007/s00228-012-1344-0

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